INTRODUCTION: The goal of this study was to investigate prevalence and morphometric parameters of pubic ligaments and the interpubic disk and its cavity using imaging methods for use in clinical medicine. METHODS: Pubic symphysis morphology was investigated in 652 patients (348 women and 304 men), from which 449 CT scans and 203 MR scans were available. The average age of men was 48 years and women 39 years. Investigated parameters included dimensions of the interpubic disk, visibility and width of the reinforcing ligaments, and visibility, dimensions, and location of the symphysial cavity. The results were compared with MR scans of 20 healthy volunteers and 21 dissected anatomic specimens. RESULTS: The craniocaudal, ventrodorsal, and mediolateral diameters of the pubic disk were 36 to 37.7, 14.8 to 15.2, and 2.2 to 4.2 mm in women and 42 to 42.3, 18.6 to 19, and 2.4 to 4.5 mm in men, respectively. Higher age correlated with shorter mediolateral diameter and larger craniocaudal and ventrodorsal diameters. The superior pubic ligament was visible in 93.1% of men (1.44 mm thick) and in 100% of women (1.7 mm); the inferior pubic ligament in 89.7% of men (1.74 mm) and 88% of women (1.95 mm), the anterior pubic ligament in 96.6% of men (1.5 mm) and 82% of women (1.34 mm); and the posterior pubic ligament in 65.5% of men (1.18 mm) and 63.7% of women (0.83 mm). A symphysial cavity was found in 24% of men and 22.9% of women, with craniocaudal, ventrodorsal, and mediolateral dimensions of 13, 10.7, and 3.2 mm in men and 9.5, 10.7, and 3 mm in women, respectively. CONCLUSION: The presented morphologic parameters provide an anatomic reference for diagnostics of pathologic conditions of the pubic symphysis. The following anatomic structures should be added to the official anatomic terminology: symphysial cavity (cavitas symphysialis), retropubic eminence (eminentia retropubica), anterior pubic ligament (ligamentum pubicum anterius), and posterior pubic ligament (ligamentum pubicum posterius). LEVEL OF EVIDENCE: II-III.

• MeSH
• Ligaments, Articular anatomy & histology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Pubic Bone diagnostic imaging   MeSH
• Tomography, X-Ray Computed MeSH
• Pubic Symphysis * diagnostic imaging   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Insuficientné zlomeniny vznikajú pri normálnej záťaži na patologicky oslabenú kosť, predovšetkým v dôsledku osteoporózy. Atypické zlomeniny femuru sú popísané ako komplikácia dlhodobého užívania bisfosfonátov. Vzhľadom k starnutiu populácie sa incidencia insuficientných fraktúr, ako aj atypických zlomenín femuru, zvyšuje. Rovnako problémom je ich včasná diagnostika, keďže na prvotnej natívnej RTG-snímke bývajú často prehliadnuté. Prezentujeme prípad pacientky, dlhodobo liečenej denosumabom, s atraumatickou zlomeninou dolného ramienka lonovej kosti. Vzhľadom k predĺženému kostnému hojeniu s neobvyklým obrazom hojenia uvažujeme nad dlhodobou antiresopčnou liečbou ako možnou príčinou vzniku zlomeniny ramienka lonovej kosti a faktorom ovplyvňujúcim hojenie insuficientnej fraktúry.

Insufficiency fractures occur in normal load on pathologically weak bone, as a result of osteoporosis. Atypical femoral fractures are well described complication of long term bisphosphonate use. With a growing geriatric population, the incidence of insufficiency fractures, as well as atypical femoral fractures, has increased. Also their early diagnostics is a problem, because they are often overlooked on first native X-ray. We present a case of patient, longterm treated with denosumab, who developed fracture of the pubic ramus. Because of delayed bone healing with unusual pattern we consider long-term anti-resorption therapy as a potentional cause of the pubic ramus fracture or factor affecting the healing of insufficiency fracture.

• MeSH
• Fracture Healing MeSH
• Bone Density Conservation Agents adverse effects   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Musculoskeletal Pain etiology   MeSH
• Pubic Bone * diagnostic imaging   injuries   MeSH
• Osteoporosis drug therapy   complications   MeSH
• Pelvis diagnostic imaging   injuries   MeSH
• Pelvic Pain etiology   MeSH
• Radiography MeSH
• Fractures, Stress * diagnostic imaging   therapy   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Fractures, Bone diagnostic imaging   etiology   MeSH
• Laparoscopy MeSH
• Humans MeSH
• Urinary Bladder * diagnostic imaging   surgery   injuries   MeSH
• Pubic Bone diagnostic imaging   injuries   MeSH
• Multiple Trauma MeSH
• Rupture MeSH
• Aged, 80 and over MeSH
• Sutures MeSH
• Accidental Falls * MeSH
• Check Tag
• Humans MeSH
• Aged, 80 and over MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Fibrous dysplasia (FD) is a benign bone lesion in which normal bone marrow is replaced by fibro-osseous tissue. The usual high fluorodeoxyglucose (F-FDG) uptake in FD may lead to the misdiagnosis of bone malignancy. Herein, we describe the case of a 42-year old man with histologically verified FD of the pubic bone, which has been subsequently examined during follow-up for rectal cancer, using both F-FDG and fluorothymidine (F-FLT) PET/CT imaging. The FD lesion was characterized by a high uptake of F-FDG (hot spot) but very low uptake of F-FLT (cold spot) as compared with the contralateral unaffected pubic bone.

• MeSH
• Dideoxynucleosides MeSH
• Adult MeSH
• Fibrous Dysplasia of Bone diagnostic imaging   MeSH
• Fluorodeoxyglucose F18 MeSH
• Humans MeSH
• Pubic Bone diagnostic imaging   MeSH
• Positron Emission Tomography Computed Tomography MeSH
• Radiopharmaceuticals MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH